When a patient has a serious, deep wound, or a large abscess, osteomyelitis, or other collections of body fluids such as serum, blood, or pus in the body, drainage catheter tubing (commonly called wound tubing) is commonly used to alleviate the situation. Commonly, the wound tubing is made of flexible plastic such as polyethylene, or inert elastomers such as silicone rubber or the like. Typically, the wound tubing is fabricated to have sufficient stiffness so that fluids can be removed through it by suction without collapsing the tubing, for example, by an evacuator such as is shown in U.S. Pat. No. 3,115,138.
The wound tubing typically is manufactured with a large number of lateral perforations for communication between the lumen or bore of the tubing and the exterior, the perforations being located in a central portion of the tubing, and the ends of the tubing being free of lateral perforations.
For emplacement in the wound site, a pointed steel awl is connected to one end of the wound tubing, to pass the tubing through healthy, intact tissue adjacent the wound in such a manner that at least one end of the wound tubing is positioned exterior of the patient, while the perforated portion lies at the wound site. Following this, excess portions of the wound tubing, and the awl, are removed by severing the tubing, and the wound site in sutured. In the past, and as disclosed in my co-pending application, Ser. No. 447,316, filed Mar. 1, 1974, the surgeon inserts the wound tubing into the wound by first using an awl to penetrate exterior skin adjacent the wound and then drawing the tubing through the perforation into the wound.
Various significant problems exist in the prior art wound tubing. First, the restless patient can accidentally, or otherwise, pull on the wound tubing and cause it to withdraw outwardly along its path through the healthy tissue. This can happen when the patient is asleep, or irrational patients and children may intentionally try to withdraw the wound tubing.
Once the wound tubing has been partially or completely withdrawn, those portions of the tubing which have been exposed to the exterior will become contaminated with bacteria, and thus should not be simply reinserted into the patient again, even if this were possible. Accordingly, a wound tubing may have to be reinserted by connecting fresh sterile wound tubing to an awl, and once again punching it through the healthy tissue into the wound site. Also, the stitches holding the wound closed may well have to be reopened in order to withdraw the awl and to re-position the wound tubing.
Furthermore, at the skin exit hole or holes of the wound tubing, there is a pronounced tendency for blood, lymph, or irrigation solution to leak outwardly, which is clearly undesirable. Also, there is the still more undesirable possibility of the migration of bacterial contamination inwardly toward the wound site along the wound tubing, and the consequent danger of infection.
Also, the perforations and the bore or lumen of the wound tubing at the wound site frequently become plugged with debris. To avoid changing of the wound tubing, there is frequently attempted a back flushing procedure, in which sterile flushing solution, such as normal saline, is passed through the wound tubing to flush the solution into the wound site. This disperses and breaks up the debris which blocks flow in the wound tubing. This technique has its consequent dangers of introducing bacterial contamination from the exterior into the wound site. The problems present with wound tubing will be recognized by one skilled as being present in tubing lodged in any body cavity, such as in the abdomen, chest, head, neck, or limbs.
In accordance with this invention, the above disadvantages are eliminated or greatly reduced in effect by the improved drainage tubing of this invention and its method of use, and an additional advantage is supplied by providing a construction that more conveniently permits insertion of the wound tubing either from within the wound or cavity site or from without the site as is best for the patient.